Individual provider Active NPI

Phyllis Rita Ventocilla, LMSW

  • Social Worker
  • Muskegon, MI
National Provider Identifier
1053941690
Registry record updated Jan 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801061129 Issued in MI
Practice address
1050 W Western Ave Ste 400
Muskegon, MI 49441-1666
Phone
(231) 728-3442
NPI assigned
Jan 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801061129 MI Primary

Addresses

Primary practice location

1050 W Western Ave Ste 400
Muskegon, MI 49441-1666

Mailing address

15686 River Side Dr
Spring Lake, MI 49456-9243
Phone (231) 728-3442

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6801061129MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hospice of Muskegon County, Inc. PastSince Jan 26, 2020 Accepting new patients
Hospice of Muskegon County, Inc. PastSince Jan 26, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1579737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1053941690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15686 RIVER SIDE DR",
            "city": "SPRING LAKE",
            "state": "MI",
            "postal_code": "494569243",
            "telephone_number": "231-728-3442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 W WESTERN AVE STE 400",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494411666",
            "telephone_number": "231-728-3442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENTOCILLA",
        "first_name": "PHYLLIS",
        "middle_name": "RITA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-23",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801061129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.